PROFESSIONALS AS KNOWLEDGE BROKERS: THE LIMITS OF AUTHORITY IN HEALTHCARE COLLABORATION
| Date | 01 June 2016 |
| Author | RUTH BOADEN,DAMIAN HODGSON,ROMAN KISLOV |
| Published date | 01 June 2016 |
| DOI | http://doi.org/10.1111/padm.12227 |
doi : 10. 1111/p adm .12227
PROFESSIONALS AS KNOWLEDGE BROKERS:
THE LIMITS OF AUTHORITY IN HEALTHCARE
COLLABORATION
ROMAN KISLOV, DAMIAN HODGSON AND RUTH BOADEN
Professionals with managerial responsibilities are often seen as natural boundary spanners,
brokering knowledge between the professional and managerial domains. However, the ten-
sions implicit in their knowledge brokering activities, especially when the latter are formalized,
remain under-researched. Using interviews and observational data, we examine the case of an
inter-organizational collaborative research partnership that deployed clinical professionals as
designated knowledge brokers across multiple sites. We identify three strategies that such hybrid
professionals utilized to surmount challenges associated with knowledge brokering in the frag-
mented healthcare context: (1) relying on additional boundary ‘bridges’; (2) conforming to existing
ways of doing things; and (3) shifting from ‘facilitating’ to ‘doing’. An analysis of these strategies
highlights the tensions between different dimensions of brokering reinforced by macro-level insti-
tutional arrangements, the intertwining of formalized and emergent elements of brokering as a
collectively enacted phenomenon, and the limitations of knowledge brokering professionals arising
from their professional expertise and authority.
INTRODUCTION
Knowledge brokers are individuals that bridge a gap in social structure and help knowl-
edge ow across that gap by facilitating interaction, exchange of ideas and negotiation
of meaning across previously separated practices, groups and organizations (Wenger
1998; Burgess and Currie 2013). Much knowledge brokering work within and across
organizations remains informal, unrecognized and embedded in local contexts (Currie
and White 2012) but public and private sector organizations increasingly acknowledge
the potential of deliberately created knowledge brokering roles in enabling the coor-
dination, collaboration and integration of different agencies and professional groups
(Ward et al. 2009; Chew et al. 2013). Institutionalized knowledge brokering can be seen
as a form of intentional boundary spanning which is based upon an expectation that the
brokered knowledge will be used in policy and practice decisions (Mitton et al. 2007), ulti-
mately inuencing the opinions and actions of knowledge recipients (Contandriopoulos
et al. 2010).
This article extends the analysis of knowledge brokering beyond the boundaries of a sin-
gle organization or profession and offers an exploration of quasi-managerial practitioners
(Causer and Exworthy 1998, p. 84) who have no formal supervisory or resource alloca-
tion duties but act as formally designated knowledge brokers in a fragmented context
of inter-organizational collaboration. While professional hybrids are often seen as natu-
ral boundary spanners (Ferlie et al. 1996; Fitzgerald and Ferlie 2000; Llewellyn 2001), our
analysis highlights that reliance on hybrid roles to make an impact on the knowledge and
learning processes can be accompanied by unwanted consequences stemming not only
from contextual constraints but also, paradoxically,from a high level of professional exper-
tise and authority. Furthermore, we demonstrate how the strategies deployed by brokers
Roman Kislov, Damian Hodgson and Ruth Boaden areat Manchester Business School, The University of Manchester,
UK.
Public Administration Vol.94, No. 2, 2016 (472–489)
© 2015 John Wiley & Sons Ltd.
PROFESSIONALS AS KNOWLEDGE BROKERS 473
to mitigate their lack of power in a fragmented context may lead to the prioritization of
more formalized aspects of knowledge brokering over its facilitative dimension, further
limit brokers’ managerial authority,and eventually result in the reinforcement of existing
institutional patterns.
The rst section provides an overview of the literature on professionals as knowledge
brokers, reecting on their hybrid nature. The second section exploresthe challenges expe-
rienced by hybrid knowledge brokers in healthcare. The procedures of data collection and
analysis are outlined in the Case and Method section. The Findings section describes the
strategies deployed by knowledge brokering professionals to mitigate their lack of power
in a constraining context. The Discussion reects on the theoretical implications of these
strategies while the Conclusion summarizes the key messages, practical implications and
limitations of the study.
PROFESSIONALS AS DESIGNATED KNOWLEDGE BROKERS
Knowledge brokers are individuals who, by participating in several communities of prac-
tice, enable translation, coordination and alignment between different perspectives and
facilitate transactions between previously separated practices (Brown and Duguid 1991;
Wenger 1998). They provide continuity of action and interaction at the boundaries, i.e.
‘sites of difference’ emerging through local negotiations and subsequently objectied in
the form of social entities (Abbott 1995; Kislov 2014). In many cases, the brokerage of
practice-based knowledge through situated interaction would be an intrinsic, and often
unrecognized, part of normal, day-to-day work practice (cf. ‘internal’ knowledge broker-
ing in Currie and White 2012, p. 1335).
We focus on designated (also referred to as institutionalized, dedicated, or nominated)
knowledge brokers, i.e. those who have an explicit remit in knowledge brokering which
constitutes their ‘core’ responsibility and takes up a signicant proportion of their time
(Knight and Lightowler 2010). Designated knowledge brokers can often be found in frag-
mented, multi-organizational contexts, such as inter-organizational information systems
development projects (Levina and Vaast 2005), voluntary public–private partnerships
(Noble and Jones 2006) and university–industry collaborations (Knight and Lightowler
2010), including collaborative research partnerships bringing together producers and
users of research (Harvey et al. 2011; Rowley et al. 2012; Chew et al. 2013). Their knowl-
edge brokering remit is often reected in their ofcial role titles, examples including
knowledge transfer associates (Harvey et al. 2011), diffusion fellows (Rowley et al. 2012)
and knowledge exchange ofcers (Knight and Lightowler 2010).
In highly professionalized contexts, such as healthcare, knowledge brokering functions
can be assigned to hybrid practitioners who move away from a purely professional role
to assume managerial responsibilities while continuing their professional practice to
maintain legitimacy with their peers (Fitzgerald et al. 2013). Such hybrids include both
managing professionals, who have a formally designated supervisory or resource allocation
responsibilities, and quasi-managerial professionals, who either full such roles informally
or have responsibilities in other areas of management, such as performance measurement,
project management or handling external relations on behalf of an organization (Causer
and Exworthy 1998). Hybrid professionals use their in-between positions to support
innovation and change through connecting, recombining and translating managerial
and professional knowledge across different individuals and groups within and outside
an organization (Fitzgerald 1994; Fitzgerald and Ferlie 2000; Burgess and Currie 2013).
Public Administration Vol.94, No. 2, 2016 (472–489)
© 2015 John Wiley& Sons Ltd.
To continue reading
Request your trial